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Social Stories: Mechanisms of Effectiveness in Increasing Game Play Skills in Children Diagnosed with Autism Spectrum Disorder Using a Pretest Posttest Repeated Measures Randomized Control Group Design

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Abstract

An increasing body of literature has indicated that social stories are an effective way to teach individuals diagnosed with autism appropriate social behavior. This study compared two formats of a social story targeting the improvement of social skills during game play using a pretest posttest repeated measures randomized control group design. A total of 45 children diagnosed with Autism Spectrum Disorder (ASD) ages 7–14 were randomly assigned to standard, directive, or control story conditions. Results demonstrated that the standard and directive story formats were equally as effective in eliciting, generalizing and maintaining the targeted social skills in participants who had prior game play experience and Verbal Comprehension Index (VCI) scores from the WISC-IV intelligence test in the borderline range or above.

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Acknowledgements

The authors would like to acknowledge Christian Quirmbach and Sharon Foster for their assistance in critiquing this study.

Author information

Authors and Affiliations

  1. California School of Professional Psychology, Alliant International University, San Diego, CA, USA

    Linda M. Quirmbach, Alan J. Lincoln, Monica J. Feinberg-Gizzo & Siri M. Andrews

  2. Yale Child Study Center, 40 Temple Street, Suite 7-G, New Haven, CT, 06510, USA

    Linda M. Quirmbach

  3. The Center for Autism Research, Evaluation and Service, San Diego, CA, USA

    Linda M. Quirmbach, Alan J. Lincoln, Monica J. Feinberg-Gizzo & Siri M. Andrews

  4. Department of Psychology, Michigan State University, San Diego, CA, USA

    Brooke R. Ingersoll

  5. Yale University, New Haven, CT, USA

    Linda M. Quirmbach

Authors
  1. Linda M. Quirmbach
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  2. Alan J. Lincoln
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  3. Monica J. Feinberg-Gizzo
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  4. Brooke R. Ingersoll
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Corresponding author

Correspondence to Linda M. Quirmbach.

Appendices

Appendix A: Playing Games (Feinberg 2001) (Standard Social Story Format)

Standard Story

  • When I go in a room it is important to say hi to the person in the room with me.

  • Sometimes this is someone I know like my teacher or my mom.

  • Sometimes it may be someone I don’t know.

  • I can say “hello” or “hi” to them.

  • Usually they will say hi back to me.

  • It makes people happy when I say hi to them.

  • Sometimes there are toys that I can play with.

  • I may see a game that I like to play.

  • If I want to play a game with a person, I should ask them. I can say, “Do you want to play with me?” or “Will you play this game with me?”

  • Sometimes the person will say yes but sometimes they may say no.

  • If they say yes I can open the game and have fun playing.

  • When I am finished playing my game, it makes other people happy if I ask, “What game do you want to play?”

  • This shows that I can share with other people.

  • I can also pick up the game and bring it over to the table. If they say yes I can open the game and have fun playing.

  • It is important to take turns.

  • Other people like it when I take turns and play nicely.

  • When I am finished playing my game it makes other people happy if I ask, “What game do you want to play?”

  • I can also say, “Your turn to pick a game.”

  • This shows that I can share with other people.

  • When they say the name of the game they want to play with me, I can say, “Yes, I will play with you.”

  • Sometimes I do not like the game the other person chooses but sharing turns makes other people feel good.

  • I like to play games with my friends.

  • I am happy and so are my friends that I play with.

Appendix B

Max (Solely Used to Add Length to the Directive Story Format)

  • Max is a boy. He is 10 years old.

  • He has black hair and green eyes. He is very tall.

  • Max likes summer time, because he can do lots of things.

  • He likes to go to the pool. It can be fun to go swimming.

  • Max also likes going to the park. He can swing or go down the slide.

  • Sometimes he plays in the sand.

  • He also likes to ride his bike. Max likes to ride really fast.

  • Sometimes he takes his dog to the park.

  • His dog is named Bo.

  • Bo is brown with white ears. He is tall like Max.

  • When it is really hot, Max and Bo jump into the lake.

  • After they swim, they dry off in the sun.

  • Bo shakes the water off his fur. Max shakes the water out of his hair.

  • Then they go home to eat a snack.

  • After a day at the park, Max and Bo like to take a nap.

Playing Games (Directive Story Format)

  • When I go in a room I will say hi to the person in the room with me.

  • I can say “hello” or “hi” to them.

  • I should ask them to play.

  • I can say, “Do you want to play with me?” or “Will you play this game with me?”

  • If they say yes I can open the game and have fun playing.

  • When I am finished playing my game,

  • I can ask, “What game do you want to play?”

  • I can also pick up the game and bring it over to the table.

  • If they say yes I can open the game, practice taking turns, and have fun playing.

  • When I am finished playing my game

  • I can ask, “What game do you want to play?”

  • I can also say, “Your turn to pick a game.

  • When they say the name of the game they want to play with me, I can say, “Yes, I will play with you.”

Appendix C: Getting Ready for School (Control Social Story)

  • Most children go to school from Monday to Friday.

  • Before I go to school each morning, it is important to be ready.

  • My parents are happy when I get out of bed as soon as they wake me up.

  • After I get out of bed, there are a lot of things to do.

  • Sometimes I take a shower in the morning.

  • Showers make me feel clean, and they can be fun.

  • After I wash myself, it is important to dry off with a towel.

  • I can rub my hair with a towel, or I can dry my hair with a blow-dryer.

  • Then it is time to put on my clothes.

  • Sometimes my parents will tell me what to wear. I usually wear a new outfit every day.

  • If it is cold outside, I can wear a sweater to keep me warm.

  • Many people like to eat breakfast. Sometimes I eat before I get dressed.

  • Sometimes I eat breakfast after I get dressed.

  • I also need to comb my hair and brush my teeth in the morning.

  • Brushing my teeth makes my breath smell good.

  • It’s a good idea to pack important things in my back-pack. I can pack a pencil and some paper.

  • I can also bring a pencil sharpener and an eraser.

  • My teacher will be happy if I remember to bring my homework.

  • Sometimes, I may bring lunch with me to school. I can put the lunch in my back-pack.

  • School usually begins at the same time every morning.

  • My mom and dad like it when I get ready on time so that I won’t be late to school.

  • Before I leave home, it’s a good idea to make sure I have everything I need in my

  • back-pack. When I get to school, I will feel good because I am clean and ready to start the day!

Appendix D: Dependent Variable Scoring Criteria from Feinberg (2001)

Greeting Behaviors

  1. 0

    No attempt to verbally or nonverbally greet examiner. Also code 0 for verbal statements not related to a greeting.

    • Examples: “I like ice cream”/“I want to go home”

  2. 1

    Child greets examiner nonverbally.

    • Examples: Child makes eye contact with, approaches, or waves to with examiner.

  3. 2

    Child greets examiner with appropriate verbal language. Child does not need to make eye contact with the examiner.

    • Examples: “Hello”/“Hi”/Hi Linda

Requesting to Play

  1. 0

    No attempt to verbally or nonverbally to request playing a game with examiner. Child may go to games in room but doesn’t approach the examiner to join. This coding also includes child walking around the room or talking with the examiner but not initiating play in any way.

  2. 1

    Child nonverbally or verbally attempts to request playing a game. This also includes child making request statements toward examiner regarding the board games.

    • Examples: Child brings a game to examiner or to the table.

    • Child may request a game, “I want to play Connect Four.”

  3. 2

    Child verbally requests to play a game with examiner.

    • Examples: “Do you want to play with me?”/“Let’s play ________.”

Asking What Another Wants to Play

  1. 0

    Child makes no verbal or nonverbal attempt to ask what examiner wants to play or indicating it is their turn to choose a game. Also code 0 for verbal statements not related to asking what the examiner wants to play, or if the child gets up and wanders around the room or ignores the examiner.

    • Examples: “I like to play games.”

    • “I want to play this game again.”

  2. 1

    Child nonverbally attempts to ask examiner what they want to play.

    • Examples: Child approaches toys and looks at examiner.

  3. 2

    Child verbally asks examiner what they want to play or verbally indicates their turn to pick the game.

    • Examples: “What game do you want to play?”/“It’s your turn to pick a game.”

Accepting Another’s Suggestion for a Game

  1. 0

    Child does not accept examiner’s choice of game. Child may refuse verbally or nonverbally.

    • Examples: “I don’t like that game.”/”No!”/Child may begin to play with other toys.

  2. 1

    Child nonverbally accepts examiner’s choice

    • Examples: Child sits down and plays without verbally stating yes.

    • Child shakes or nods head yes.

  3. 2

    Clear verbal acceptance of examiner’s choice of game.

    • Examples: “Yes”/“Sure”/“Uh-huh”/“Yes, I will play that with you.”

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Quirmbach, L.M., Lincoln, A.J., Feinberg-Gizzo, M.J. et al. Social Stories: Mechanisms of Effectiveness in Increasing Game Play Skills in Children Diagnosed with Autism Spectrum Disorder Using a Pretest Posttest Repeated Measures Randomized Control Group Design. J Autism Dev Disord 39, 299–321 (2009). https://doi.org/10.1007/s10803-008-0628-9

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  • DOI: https://doi.org/10.1007/s10803-008-0628-9

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